Brain injury at birth – a better start for newborns

Newborn babies who suffer brain injury at birth could face significantly less risk of disability, thanks to a new treatment developed by Hudson Institute and Monash University scientists.

Brain injury at birth (neonatal asphyxia), or severe oxygen shortage occurs in about three in every 1,000 births in Australia, causing death or disability in around 50 per cent of these babies.

The lack of oxygen causes a syndrome known as neonatal encephalopathy, with typical signs including newborns with decreased consciousness, floppiness or having fits. This syndrome is a common cause of disabilities such as cerebral palsy.

New brain injury treatment hope

The current treatment is therapeutic hypothermia (or whole-body cooling) which reduces rates of serious brain injury and long-term disability, but many infants still suffer serious long-term effects. A proposed new therapy from Hudson Institute gives families hope for far better health outcomes.

In their pre-clinical study, published in the Journal of Pineal Research, Professor Suzanne Miller’s team combined the current treatment of therapeutic hypothermia with melatonin (cooling+MLT), achieving significantly better results.

 “Hypothermia reduces the risk of death or disability by around 30 per cent, but hypothermia alone is not sufficient. Brain injury at birth causes an influx of oxygen free radicals. The path we have chosen is to target those free radicals with melatonin,” Professor Miller said.

Melatonin, a powerful anti-inflammatory

While melatonin is best known for its role in driving the body’s sleep and wake cycle, it is also a powerful antioxidant and anti-inflammatory.

Professor Suzanne Miller said: “In many cases, we never know what causes the lack of oxygen to the baby, so effective treatment after birth is crucial”.

International clinical trial for newborn brain injury

Professor Miller said the pre-clinical results had been very positive and researchers were aiming to begin a large international clinical trial, and are now collaborating with teams in the UK and New Zealand.

Professor Miller’s team examined whether melatonin provided added benefit when combined with therapeutic hypothermia (TH) compared to TH alone or melatonin alone, to improve recovery from acute encephalopathy. The study demonstrated that combined TH and melatonin provided significantly greater neuroprotection than either alone.

Associate Professor Atul Malhotra, Clinical Associate at Hudson Institute, study co-author and neonatologist at Monash Children’s Hospital, said hopefully this therapy for neonatal encephalopathy will provide babies and families a better chance of a life without disability.